In line with minimally invasive surgery (MIS), flexible endoscopy is used to inspect and treat disorders of the gastrointestinal (GI) tract without the need for creating an artificial opening on the patient's body. The endoscope is introduced via the mouth or anus into the upper or lower GI tracts respectively. A miniature camera at the distal end captures images of the GI wall that help the clinician in his/her diagnosis of the GI diseases. Simple surgical procedures (like polypectomy and biopsy) can be performed by introducing a flexible tool via a working channel to reach the site of interest at the distal end. The types of procedures that can be performed in this manner are limited by the lack of manoeuvrability of the tool. More technically demanding surgical procedures like hemostasis for arterial bleeding, suturing to mend a perforation, fundoplication for gastrooesophageal reflux cannot be effectively achieved with flexible endoscopy. These procedures are often presently being performed under open or laparoscopic surgeries.
Endoscopic submucosal dissection (ESD) is mostly performed using standard endoscope with endoscopically deployed knifes. Performing ESD thus requires tremendous amounts of skill on the part of the endoscopist and takes much time to complete. Furthermore, constraint in instrumental control makes it prone to procedural complications such as delayed bleeding, significant bleeding, perforation, and surgical procedural complications. Although ESD is increasingly recognized as an effective procedure for the treatment of early-stage gastric cancers, due to these problems, ESD remains a procedure performed only by the most skilled endoscopists or surgeons. Severe limitations in the manoeuvring of multiple instruments within the gastric lumen pose a major challenge to the endoluminal operation. Natural force transmission from the operator is also hampered by the sheer length of the endoscope, resulting in diminished, and often, insufficient force at the effector end for effectual manipulations. Besides, as all instruments are deployed in line with the axis of the endoscope, off-axis motions (e.g. triangulation of the instruments) are rendered impossible.
Natural Orifices Transluminal Endoscopic Surgery (NOTES), a surgery using the mouth, anus, vaginal, nose to gain entry into the body) is a method used for surgery that does not require any percutaneous incisions on the abdominal wall. However, for NOTES to be used on human safely, many technical issues need to be addressed. Out of which tooling for fast and safe access and closure of abdominal cavity and spatial orientation during operation are of paramount importance.
With the invention of medical robots like the surgical systems sold under the trademark DA VINCI®, clinicians are now able to maneuver surgical tools accurately and easily within the human body. Operating from a master console, the clinician is able to control the movements of laparoscopic surgical tools real time. These tools are commonly known as slaves. However, master-slave surgical robotic systems are rigid and the slave manipulators enter the human body by means of incisions.
Diseases of the GI tract such as, for example, peptic ulcer, gastric cancer, colorectal neoplasms, and so forth, are common in most countries. These conditions can be diagnosed with the aid of the flexible endoscopes. Endoscopes incorporate advanced video, computer, material, and engineering technologies. However, endoscopists often still complain of the technical difficulties involved in introducing long, flexible shafts into the patient's anus or mouth and there is still a tool lacking to carry out GI surgeries without creating an incision in the human body and over as short a time as possible since time is an essence during acute GI bleeding.